We never expect that our relaxing vacation will include a trip to the waiting room of a hospital or medical clinic but accidents and medical emergencies do happen while travelling. As Canadians, we are accustomed to providing our Provincial Health number at the hospital and being treated without having to pay for services. Follow up tests and having a prescription cannot only be an inconvenience, but an unexpected expense. Unfortunately when medical interventions are required while travelling outside of Canada, the process of paying for treatment and submitting a claim back home is more involved.
Many providers and/or medical facilities outside of Canada do not bill directly to Third-Party Insurers or to Provincial Government Plans. It is important to understand what may be required when you are travelling and require emergency medical attention in addition to fully understanding the requirements of your insurance carrier.
Here are some important tips should the unforeseen happen while you are travelling outside of Canada:
- When travelling, always make sure you are carrying your travel insurance information, benefit or policy numbers as well as your provincial health card and a valid piece of ID (preferably a valid passport).
- Should an emergency occur, make sure that you or someone you are travelling with contact the emergency travel number provided with your emergency travel insurance to ensure that coordination between the hospital and insurer regarding treatment and billing is timely. Many insurance carriers require notification within 15 days of treatment.
- If the facility where you received care does not work directly with Out of Country insurance carriers, you may be required to pay for the treatment or a portion of the treatment before you can be discharged. Alternatively, you may be required to sign a document as a guarantor for the expenses incurred. Make sure you receive original detailed invoices (preferably in English) for any services you have paid for. These documents will be required by all plans for adjudication and reimbursement of your claim.
For Out-of-Country emergency medical expenses, your provincial plan is always first payer. Any remaining balance after assessment and adjudication by your provincial health plan is then considered by your group or individual travel coverage. Contact your insurance provider or Plan Member Advocacy Team to help navigate through the process of out of country claim reimbursement.